An Ultimate Guide to The Most Important Acne Terms

Let’s start with an easy one.

Acne vulgaris is a skin disease that occurs when ahair follicle(pore, an opening in the skin)becomes clogged with dead skin andsebum (oil from the skin). This may or may not include infection and inflammation. The termacne typically comprises ofblackheads, whiteheads, papules, pustules, cysts, andnodules, and can be found on the face, chest, shoulders, and back.Although acnemost commonly refers to acnevulgaris, it is only one subtype of acne.

Acomedo is a basic acne lesion, a hair follicle that becomes clogged with oil and dead skin. Ablackhead forms when the pore remains openandis exposed to air, which oxidizes it to turn black. Awhitehead occurs when skin covers the pore. If you squeeze either (you shouldn’t), hard plugs come out.Blackheads and whiteheads are considerednon-inflammatory acne.However,sometimes thesecomedones can also be infected or inflamed, leading to one of the following stages of acne.

Papules arecomedones that become inflamed, forming small bumps on the skin that can be red or pink. They are often firm andmay betender to touch. Squeezing may lead to worsened inflammation and potentialscarring. These bumps lack the white head that indicates apustule.

Likepapules,pustules are inflamedcomedones. However, pustules are filled with white or yellow pus, which is a buildup of the dead white blood cells your bodysends in response to the infection. Pustules are usually accompanied by redness. Like all other stages of acne, picking and poppingleads to worsened inflammation and scarring.

Nodules are large, inflamedpapules. Due to the buildup of pressure, the follicle wall ruptures and allows leakage (bacteria, oil, dead skin) into the dermis. These are often firm to the touch and are quite “deep” and painful. These should be treated exclusively by a dermatologist.

Cysts are large, pus-filled bumps that resemble boils. Like many of the stages before it, cysts can be painful. Some cysts can last a very long time and should be treated by a dermatologist. People who developnodulesand cysts generally have a moresevere acne.

Mild acne generally consists of fewer than 30 totalbumps (whiteheads, blackheads, papules, pustules, the occasionalcyst ornodule). Mild acne, while persistent, is usually treatable with over-the-counter products.

Moderate acne separates itself from mild acne when thereis 100 or so total bumps present (only occasionalcystsornodules). Like mild acne, moderate acne may be treated with over-the-counter products but may require a prescription medication for faster and more dramatic results.

Severe ornodulocystic acne is a term reserved for those who may have hundreds of total lesions, including multiple inflamedcystsandnodules. This type of acne can be especially painful and difficult to treat. Bumps can become large and often leave scars, which makestimely treatment even more crucial. Severe acneis commonly treated with our current most effective treatment for severe acne,which isAccutane.

Acnecosmetica is causedby using skin care products thatclog your pores. This includes moisturizers,makeup andsunscreen. It is a mild but persistent form of acne and can occur almost anywhere on the body, although the face, neck, hairline, and scalp are the most common sites. It appears as small bumps across the surface of the skin that are usually uniform in nature, and often produce no other symptoms.

Acnemechanica is a common form of acne caused by heat, friction, and pressure against the skin. This most commonly results from using straps or headgear in sports, but can also occur from wearing baseball hats, headbands, headsets and anything else in extended contact with your skin.

Acneconglobata isa rare but severe form ofnodulocysticacne, most typical in men taking steroids but which also occurs in women. It results innodulesconnected to othernodules under the skin and can affect our jaw, neck, chest, arms, back, and buttocks. Like nodulocystic acne of the face, it requires timely dermatological treatment and often a course ofAccutane.

This type of acne is also a rare and severe form of the disease, resulting inthesudden death of skin cells. It contains granulomas (ulcers) and crusted, bleeding acne lesions. Acne fulminans is usually also accompanied by fever, joint pain,and swelling of the spleen and liver. It may occur after an unsuccessful high doseAccutane treatment foracneconglobata and is still not well understood.

Pyodermafacialeresembles severenodulocystic acne, with large, red, painful bumps typically on the forehead, nose, and chin.It always occurs suddenly, and mostly in young adult womenbecause of emotional distress.

Acneinversa is associated with inflamed and swollen lumpsin the sweat-producing glands (armpits, nipples, buttocks, and genitals). These lumps are typically painful, similar in appearance tonodulocystic acne,and may break open and drain. Although genetic factors probably play a role, it also seems to be triggered by stress, hormonal changes, obesity and smoking, and typically requires aggressive treatment.

Acneaestivalis is a seasonal disorder, usually peaking in summer and disappearing before winter.It is characterized by tiny, red, dome-shaped papules that are all uniform in nature. They spring up suddenly and may last for weeks, typically resulting fromenthusiastic sunbathing and exposure to UV-A light. It occurs in people even with no prior history ofacne vulgaris. While they can be found on the face, they mostly occur on the arms, shoulders, back, and chest. While they generally go away on their own, it may take several weeks.

As the name suggests,drug-induced acne results from taking systemic drugs (usually steroids, but also lithium, B12, thyroid hormones, iodine, antibiotics and many others). Likeacneaestivalis,this type of acne is generally uniform, but consists ofredpapulesandpustules, usually on the body or at the site of application.

Pseudo-acne is acne that’s not really acne. Many skin conditions can easily be mistaken for acne bumps. For other skin conditions that look like acne,read our blog post here.

Androgens are hormones that can prompt the sebaceous glands to produce more oil which may clog pores andresult in acne. This generally accounts for the acne that results during hormonal changes (puberty) but can also include androgen-sensitive receptors in the skin.

Bacteria are one-celled organisms that exist in our bodies and on our skin naturally (our resident or “good” bacteria), but which can sometimes also be pathogenic or “bad” bacteria that cause acne and other diseases.

It’s easy to confuse breaking out with purging and vice versa, making it harder to pinpoint the cause of our flare-up. Purging results from the use of products that affect how our skin cells shed, while breakouts can happenbecause of any number of factors. To learn the difference between purging and breaking out,check out our article here.

Hyperpigmentation occurs whenareas of the skin become darker than the surrounding skin (age spots, liver spots, freckles, sun spots and melasma); post-inflammatory hyperpigmentation (PIH) occurs when a skin injury heals and leaves discoloration behind.People with darker skin are more prone, and sun exposure generally worsens pigmentation issues. Although similar in nature, PIH is sometimes confused forpost-inflammatory erythema which is a pink or purple mark seen in lighter skin.

Hypopigmentation is the loss of skin color, caused by disease, injury, burns or other trauma to the skin, and is harder to treat than hyperpigmentation.

Ice-pick scars are deep, narrow scars that look like theyare made with a pin (or an ice-pick). They usually requiretreatments such asdermabrasion,microneedling,laser resurfacing, punch grafting,subcision, and excision.

Boxcar scars are shallow indents in the skin with defined edges. They usually requiretreatments such asdermabrasion,microneedling, laser resurfacing, punch grafting,subcision, and excision.

Rolling scars are also shallow indents in the skin, butwith sloping edges. The use of soft tissue augmentation,dermabrasion,microneedling,andlaser resurfacing may helpreduce their appearance. 

Hypertrophic and keloid scars appear as thick, raised scars. Keloid scars sometimes develop outside of the damaged area.

If you’re prone to hypertrophic scarring, consult with your doctor and avoid treatments likemicroneedling.

Microneedling is a procedure that involves using a tool to make thousands of tiny (painless) punctures in the skin. This controlled trauma induces collagen and elastin formation and is asimple and effective way to get the most out of your skin care products (to allow them to penetrate better), as well as to improve the appearance of dyspigmentation andscarring.Microneedling can be done with a dermatologist, but there are safe at-home tools to use, too.

Likemicroneedling,dermabrasion produces changes to the skin by injuring it in a controlled way.Microdermabrasion involvesthe superficial layer of dead skin, resultingina temporarily improved appearance, whichshould not be used when you have active acne.

Dermabrasion, however, is especially helpful for treating acne scars.

Laser resurfacing is also used for acne scarring and dyspigmentation issues but involves a more invasive procedure. Laser resurfacing directs concentrated pulses of light at areas of concern, removing the skin layer by layer. As the skin heals it produces newer, healthier-looking cells that can improve the skin’s appearance.

AHAs are alpha hydroxy acids (like glycolic andlactic acid) that work to exfoliate the skin at the surface level, to reduce the appearance of wrinkles, dyspigmentation and sun damage.

BHAs are beta hydroxy acids, exclusively salicylic acid in skin care, which works to exfoliate the skin on the surfaceandinside the pore as well as provide anti-inflammatory effects. It’s ideal for oily and acne-prone skin. These hydroxy acidsare also used inchemical peels,acids applied to the skin in high concentrations so that smoother skin can surface.

Retinoids are derivatives or related compounds of vitamin A. Retinoids regulate cell growth which unclogs pores, boosts collagen and speeds cell turnover for better exfoliation. This canimprove skin discoloration and texture.

Benzoyl peroxide works by killing acne-causing bacteria and shedding dead skin cells, which prevents pores from becoming clogged. Interestingly, it is on theWorld Health Organization’s List of Essential Medicines, the most effective and safe medicines needed in a health system. It can be found in over-the-counter medications, as well as in prescription-strength formulas, and is highly effectivein treating acne.

Antibiotics are a popular acne treatment with dermatologists because they work to kill acne-causing bacteria (along with good bacteria).Theseare given in oral or topical formulas. Common scripts includedoxycycline, minocycline, and erythromycin. However, antibiotics arenot the best option for acne treatment.

Accutane is a systemic treatment form of vitamin A used primarily to treat severe acne. It is taken by mouth at a dosage determined by your doctor for a course of several months. It appears to reduce the size of oil glands and enables the skin to renew itself better.Although Accutanedoes have some side effects, it has a long-standing history of safety and efficacy in treating acne and is considered one of thebest acne treatments around (although relapse is still possible).

While comedogenic isa termintended to express the likelihood that a product will result in clogged pores and acne, thebasis on which most products are judged isentirely subjective. While non-comedogenic products may have less likelihood of causing breakouts, not everyone will experience one.

We hope you find this glossary of the mostimportant acne terms useful! If you have any questions or comments, feel free to leave them below!